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Erschienen in: Wiener klinische Wochenschrift 9-10/2017

01.05.2017 | original article

Evaluation of left ventricular functions in patients with primary hyperparathyroidism: is there any effect of parathyroidectomy?

verfasst von: Assoc. Prof. Alper Kepez, Mehmet Yasar, MD, Assoc. Prof. Murat Sunbul, Cigdem Ileri, MD, Prof. Oguzhan Deyneli, Prof. Bulent Mutlu, Prof. Osman Yesildag, Prof. Yelda Basaran

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 9-10/2017

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Summary

Purpose

Our aim was to evaluate left ventricular (LV) systolic and diastolic functions of primary hyperparathyroidism (pHPT) patients with detailed echocardiographic analysis and investigate the effect of parathyroidectomy on echocardiographic parameters.

Methods

A total of 22 eligible consecutive patients with pHPT who underwent parathyroidectomy operation were recruited to the study. Another 22 subjects with similar age, gender and frequency of cardiovascular risk factors compared to patients were used as a control group. Echocardiographic parameters of patients scheduled for parathyroidectomy were compared to healthy matched controls. Echocardiographic parameters measured 6 months after the operation were also compared with preoperative values for each patient.

Results

Patients had higher LV mass index compared with controls. There were no significant differences between groups regarding 2D echocardiographic parameters reflecting LV systolic function and tissue Doppler velocities; however, 2D echocardiographic parameters demonstrated impairment in LV diastolic functions compared with controls. Speckle tracking echocardiography (STE) demonstrated similar LV global longitudinal systolic strain; however, left atrial conduit and reservoir functions were significantly reduced in patients with pHPT. In general, there were no significant differences between baseline and postoperative state regarding parameters reflecting LV systolic and diastolic functions; however, STE demonstrated significantly increased LV global longitudinal strain after surgery (22.3 ± 3.3% vs 20.3 ± 2.9%, p = 0.026).

Conclusion

Patients with pHPT displayed higher LV mass and impairment in LV diastolic function compared with controls. Parathyroidectomy did not lead to significant improvements in LV mass or LV diastolic function; however, subtle but not apparent increases in LV systolic function were observed 6 months after surgery.
Literatur
1.
Zurück zum Zitat Andersson P, Rydberg E, Willenheimer R. Primary hyperparathyroidism and heart disease – a review. Eur Heart J. 2004;25:1776–87.CrossRefPubMed Andersson P, Rydberg E, Willenheimer R. Primary hyperparathyroidism and heart disease – a review. Eur Heart J. 2004;25:1776–87.CrossRefPubMed
2.
Zurück zum Zitat Hedback G, Tisell LE, Bengtsson BA, Hedman I, Oden A. Premature death in patients operated on for primary hyperparathyroidism. World J Surg. 1990;14:829–35.CrossRefPubMed Hedback G, Tisell LE, Bengtsson BA, Hedman I, Oden A. Premature death in patients operated on for primary hyperparathyroidism. World J Surg. 1990;14:829–35.CrossRefPubMed
3.
Zurück zum Zitat Hedback G, Oden A. Increased risk of death from primary hyperparathyroidism-an update. Eur J Clin Invest. 1998;28:271–6.CrossRefPubMed Hedback G, Oden A. Increased risk of death from primary hyperparathyroidism-an update. Eur J Clin Invest. 1998;28:271–6.CrossRefPubMed
4.
Zurück zum Zitat Nillson IL, Yin L, Lundgren E, Rastad J, Ekbom A. Clinical presentation of primary hyperparathyroidism in Europe-nationwide cohort analysis on mortality from nonmalignant causes. J Bone Miner Res. 2002;17(Suppl 2):N68–N74. Nillson IL, Yin L, Lundgren E, Rastad J, Ekbom A. Clinical presentation of primary hyperparathyroidism in Europe-nationwide cohort analysis on mortality from nonmalignant causes. J Bone Miner Res. 2002;17(Suppl 2):N68–N74.
5.
Zurück zum Zitat Lafferty F. Primary hyperparathyroidism. Changing clinical spectrum, prevalence of hypertension and discriminant analysis of laboratory tests. Arch Intern Med. 1986;141:1761.CrossRef Lafferty F. Primary hyperparathyroidism. Changing clinical spectrum, prevalence of hypertension and discriminant analysis of laboratory tests. Arch Intern Med. 1986;141:1761.CrossRef
6.
Zurück zum Zitat Längle F, Abela C, Koller-Strametz J, et al. Primary hyperparathyroidism and the heart: cardiac abnormalities correlated to clinical and biochemical data. World J Surg. 1994;18:619–24.CrossRefPubMed Längle F, Abela C, Koller-Strametz J, et al. Primary hyperparathyroidism and the heart: cardiac abnormalities correlated to clinical and biochemical data. World J Surg. 1994;18:619–24.CrossRefPubMed
7.
Zurück zum Zitat Schluter KD, Weber M, Piper HM. Parathyroid hormone induces protein kinase C but not adenylate cyclase in adult cardiomyocytes and regulates cyclic AMP levels via protein kinase C‑dependent phosphodiesterase activity. Biochem J. 1995;310:439–44.CrossRefPubMedPubMedCentral Schluter KD, Weber M, Piper HM. Parathyroid hormone induces protein kinase C but not adenylate cyclase in adult cardiomyocytes and regulates cyclic AMP levels via protein kinase C‑dependent phosphodiesterase activity. Biochem J. 1995;310:439–44.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Piovesan A, Molineri N, Casasso F, et al. Left ventricular hypertrophy in primary hyperparathyroidism. Effects of successful parathyroidectomy. Clin Endocrinol (Oxf). 1999;50:321–8.CrossRef Piovesan A, Molineri N, Casasso F, et al. Left ventricular hypertrophy in primary hyperparathyroidism. Effects of successful parathyroidectomy. Clin Endocrinol (Oxf). 1999;50:321–8.CrossRef
9.
Zurück zum Zitat Kovacs L, Goth MI, Szabolcs I, et al. The effect of surgical treatment on secondary hyperaldosteronism and the relative hyperinsulinemia in primary hyperparathyroidism. Eur J Endocrinol. 1998;138:543–7.CrossRefPubMed Kovacs L, Goth MI, Szabolcs I, et al. The effect of surgical treatment on secondary hyperaldosteronism and the relative hyperinsulinemia in primary hyperparathyroidism. Eur J Endocrinol. 1998;138:543–7.CrossRefPubMed
10.
Zurück zum Zitat Nuzzo V, Tauchmanova L, Fonderico F, et al. Increased intima-media thickness of the carotid artery wall, normal blood pressure profile and normal left ventricular mass in subjects with primary hyperparathyroidism. Eur J Endocrinol. 2002;147:453–9.CrossRefPubMed Nuzzo V, Tauchmanova L, Fonderico F, et al. Increased intima-media thickness of the carotid artery wall, normal blood pressure profile and normal left ventricular mass in subjects with primary hyperparathyroidism. Eur J Endocrinol. 2002;147:453–9.CrossRefPubMed
11.
Zurück zum Zitat Bukoski RD, Ishibashi K, Bian K. Vascular actions of the calcium-regulating hormones. Semin Nephrol. 1995;15:536–49.PubMed Bukoski RD, Ishibashi K, Bian K. Vascular actions of the calcium-regulating hormones. Semin Nephrol. 1995;15:536–49.PubMed
12.
Zurück zum Zitat Isales CM, Sumpio B, Bollag RJ, et al. Functional parathyroid hormone receptors are present in an umbilical vein endothelial cell line. Am J Physiol Endocrinol Metab. 2000;279:654–62. Isales CM, Sumpio B, Bollag RJ, et al. Functional parathyroid hormone receptors are present in an umbilical vein endothelial cell line. Am J Physiol Endocrinol Metab. 2000;279:654–62.
13.
Zurück zum Zitat Kosch M, Hausberg M, Vormbrock K, et al. Studies on flow-mediated vasodilation and intima-media thickness of the brachial artery in patients with primary hyperparathyroidism. Am J Hypertens. 2000;13:759–64.CrossRefPubMed Kosch M, Hausberg M, Vormbrock K, et al. Studies on flow-mediated vasodilation and intima-media thickness of the brachial artery in patients with primary hyperparathyroidism. Am J Hypertens. 2000;13:759–64.CrossRefPubMed
14.
Zurück zum Zitat Mondillo S, Galderisi M, Mele D, et al. Speckle-tracking echocardiography: a new technique for assessing myocardial function. J Ultrasound Med. 2011;30:71–83.CrossRefPubMed Mondillo S, Galderisi M, Mele D, et al. Speckle-tracking echocardiography: a new technique for assessing myocardial function. J Ultrasound Med. 2011;30:71–83.CrossRefPubMed
15.
Zurück zum Zitat Fallo F, Camporese G, Capitelli E, Andreozzi GM, Mantero F, Lumachi F. Ultrasound evaluation of carotid artery in primary hyperparathyroidism. J Clin Endocrinol Metab. 2003;88:2096–9.CrossRefPubMed Fallo F, Camporese G, Capitelli E, Andreozzi GM, Mantero F, Lumachi F. Ultrasound evaluation of carotid artery in primary hyperparathyroidism. J Clin Endocrinol Metab. 2003;88:2096–9.CrossRefPubMed
16.
Zurück zum Zitat Kepez A, Harmanci A, Hazirolan T, et al. Evaluation of subclinical coronary atherosclerosis in mild asymptomatic primary hyperparathyroidism patients. Int J Cardiovasc Imaging. 2009;25:187–93.CrossRefPubMed Kepez A, Harmanci A, Hazirolan T, et al. Evaluation of subclinical coronary atherosclerosis in mild asymptomatic primary hyperparathyroidism patients. Int J Cardiovasc Imaging. 2009;25:187–93.CrossRefPubMed
17.
Zurück zum Zitat Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977;55:613–8.CrossRefPubMed Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977;55:613–8.CrossRefPubMed
18.
Zurück zum Zitat Smogorzewski M, Zayed M, Zhang YB, et al. Parathyroid hormone increases cytosolic calcium concentration in adult rat cardiac myocytes. Am J Physiol. 1993;269:J1998–H2006. Smogorzewski M, Zayed M, Zhang YB, et al. Parathyroid hormone increases cytosolic calcium concentration in adult rat cardiac myocytes. Am J Physiol. 1993;269:J1998–H2006.
19.
Zurück zum Zitat Baczynski R, Massry SG, Kohan R, et al. Effect of parathyroid hormone on myocardial energy metabolism in the rat. Kidney Int. 1985;27:718–25.CrossRefPubMed Baczynski R, Massry SG, Kohan R, et al. Effect of parathyroid hormone on myocardial energy metabolism in the rat. Kidney Int. 1985;27:718–25.CrossRefPubMed
20.
Zurück zum Zitat Smogorzewski M, Perna AF, Borum PR, et al. Fatty acid oxidation in the myocardium: effects of parathyroid hormone and CRF. Kidney Int. 1998;34:797–803.CrossRef Smogorzewski M, Perna AF, Borum PR, et al. Fatty acid oxidation in the myocardium: effects of parathyroid hormone and CRF. Kidney Int. 1998;34:797–803.CrossRef
21.
Zurück zum Zitat Nilsson IL, Aberg J, Rastad J, Lind L. Left ventricular systolic and diastolic function and exercise testing in primary hyperparathyroidism: effects of parathyroidectomy. Surgery. 2000;128:895–902.CrossRefPubMed Nilsson IL, Aberg J, Rastad J, Lind L. Left ventricular systolic and diastolic function and exercise testing in primary hyperparathyroidism: effects of parathyroidectomy. Surgery. 2000;128:895–902.CrossRefPubMed
22.
Zurück zum Zitat Barletta G, De Feo ML, Del Bene R, et al. Cardiovascular effects of parathyroid hormone: a study in healthy subjects and normotensive patients with mild primary hyperparathyroidism. J Clin Endocrinol Metab. 2000;85:1815–21.PubMed Barletta G, De Feo ML, Del Bene R, et al. Cardiovascular effects of parathyroid hormone: a study in healthy subjects and normotensive patients with mild primary hyperparathyroidism. J Clin Endocrinol Metab. 2000;85:1815–21.PubMed
23.
Zurück zum Zitat Ohara N, Hiramatsu K, Shigematsu S, et al. Effect of parathyroid hormone on left ventricular diastolic function in patients with primary hyperparathyroidism. Miner Electrolyte Metab. 1995;21:63–6.PubMed Ohara N, Hiramatsu K, Shigematsu S, et al. Effect of parathyroid hormone on left ventricular diastolic function in patients with primary hyperparathyroidism. Miner Electrolyte Metab. 1995;21:63–6.PubMed
24.
Zurück zum Zitat Almqvist EG, Bondeson AG, Bondeson L, et al. Cardiac dysfunction in mild primary hyperparathyroidism assessed by radionuclide angiography and echocardiography before and after parathyroidectomy. Surgery. 2002;132:1126–32.CrossRefPubMed Almqvist EG, Bondeson AG, Bondeson L, et al. Cardiac dysfunction in mild primary hyperparathyroidism assessed by radionuclide angiography and echocardiography before and after parathyroidectomy. Surgery. 2002;132:1126–32.CrossRefPubMed
25.
Zurück zum Zitat Dalberg K, Brodin LA, Juhlin-Dannfelt A, et al. Cardiac function in primary hyperparathyroidism before and after operation. An echocardiographic study. Eur J Surg. 1996;162:171–6.PubMed Dalberg K, Brodin LA, Juhlin-Dannfelt A, et al. Cardiac function in primary hyperparathyroidism before and after operation. An echocardiographic study. Eur J Surg. 1996;162:171–6.PubMed
26.
Zurück zum Zitat Näppi S, Saha H, Virtanen V, et al. Left ventricular structure and function in primary hyperparathyroidism before and after parathyroidectomy. Cardiology. 2000;93:229–33.CrossRefPubMed Näppi S, Saha H, Virtanen V, et al. Left ventricular structure and function in primary hyperparathyroidism before and after parathyroidectomy. Cardiology. 2000;93:229–33.CrossRefPubMed
27.
Zurück zum Zitat Baykan M, Erem C, Erdogan T, et al. Assessment of left ventricular diastolic function and the Tei index by tissue Doppler imaging in patients with primary hyperparathyroidism. Clin Endocrinol (Oxf). 2007;66:483–8. Baykan M, Erem C, Erdogan T, et al. Assessment of left ventricular diastolic function and the Tei index by tissue Doppler imaging in patients with primary hyperparathyroidism. Clin Endocrinol (Oxf). 2007;66:483–8.
28.
Zurück zum Zitat Sunbul M, Bozbay M, Mammadov C, et al. Effect of vitamin D deficiency and supplementation on myocardial deformation parameters and epicardial fat thickness in patients free of cardiovascular risk. Int J Cardiovasc Imaging. 2015;31:765–72.CrossRefPubMed Sunbul M, Bozbay M, Mammadov C, et al. Effect of vitamin D deficiency and supplementation on myocardial deformation parameters and epicardial fat thickness in patients free of cardiovascular risk. Int J Cardiovasc Imaging. 2015;31:765–72.CrossRefPubMed
Metadaten
Titel
Evaluation of left ventricular functions in patients with primary hyperparathyroidism: is there any effect of parathyroidectomy?
verfasst von
Assoc. Prof. Alper Kepez
Mehmet Yasar, MD
Assoc. Prof. Murat Sunbul
Cigdem Ileri, MD
Prof. Oguzhan Deyneli
Prof. Bulent Mutlu
Prof. Osman Yesildag
Prof. Yelda Basaran
Publikationsdatum
01.05.2017
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 9-10/2017
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-017-1186-y

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